Access apparatus with integrated fluid connector and control valve

ABSTRACT

An access apparatus includes an access housing, an access member extending from the access housing, a fluid connector mounted to the access housing and a control valve mounted to the fluid connector. The control valve is positionable relative to the fluid connector between a first position corresponding to a desufflation operative state permitting rapid desufflation of the underlying body cavity, a second position corresponding to an insufflation operative state permitting insufflation fluid flow into the access member and into the underlying body cavity, and a third position corresponding to a closed operative state.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application Ser. No. 62/555,231 filed Sep. 7, 2017, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND 1. Technical Field

The present disclosure relates to an access apparatus and, moreparticularly, relates to an access apparatus including an integratedfluid connector and valve for controlling flow of insufflation fluidsduring a laparoscopic procedure.

2. Description of Related Art

In laparoscopic procedures, clinicians perform surgery in the interiorof the abdomen through one or more narrow tubes or cannulas insertedthrough small entrance openings or incisions in the skin. In certaininstances, an insufflation port associated with one cannula provides apressurized gas, e.g., CO₂, into the abdominal cavity after the cannulais inserted into the entrance opening and secured to a patient, thuscreating or maintaining a pneumoperitoneum. The gas provides positivepressure raising the inner abdominal wall from internal organs, therebyproviding the clinician with an operating space in which a surgicalprocedure is performed. By creating the operating space, the clinicianavoids contact with the organs while the instruments are manipulatedwithin the cannulas.

A conventional cannula typically includes a luer connector and stop cockvalve to control flow of insufflation fluids. The cannula also mayincorporate a seal system having an object seal for establishing a sealabout a surgical object, e.g., a surgical instrument, introduced throughthe cannula, and a zero-closure valve for preventing release of thepressurized gas through the cannula in the absence of the surgicalobject. In some of the larger diameter cannulas, the seal system may bedetachable relative to the cannula, which assists in release of theinsufflation gases from the abdomen subsequent to performance of theprocedure.

SUMMARY

Accordingly, the present disclosure is directed to improvements incontrolling entry and exit of insufflation fluids through an accessapparatus such as a cannula, particularly, a cannula of relatively smalldiameter, e.g., 5 millimeters (mm) or less and devoid of a removableseal system. In one embodiment, an access apparatus includes an accesshousing, an access member extending from the access housing, a fluidconnector mounted to the access housing and a control valve. The accesshousing and the access member define a central longitudinal axis and alongitudinal opening for passage of a surgical object. The fluidconnector includes a valve chamber segment and a coupler segmentdepending radially outwardly relative to the valve chamber segment. Thefluid connector defines a fluid passage extending through at least thevalve chamber segment and the coupler segment. The valve chamber segmentdefines a chamber exit port in fluid communication with the fluidpassage. The coupler segment is configured for coupling to aninsufflation fluid source. The control valve includes a valve stem atleast partially positioned within the valve chamber segment. The valvestem includes a valve channel extending through the valve stem and avalve intake port in fluid communication with the valve channel. Thecontrol valve is selectively positionable between a first positioncorresponding to a desufflation operative state where the valve intakeport is in fluid communication with the access member and the valvechannel is in fluid communication with the chamber exit port of thefluid connector to thereby permit exit of the insufflation fluidsrelative to the access member, a second position corresponding to aninsufflation operative state where the valve channel is in fluidcommunication with the fluid passage of the fluid connector to permitpassage of insufflation fluids from the insufflation fluid source to theaccess member, and a third position corresponding to a closed operativestate where the valve stem intersects the fluid passage to preventegress of insufflation fluids from the access member, and maintain,e.g., a pneumoperitoneum.

In embodiments, the control valve is configured to rotate about an axisof rotation between the first, second and third positions. In someembodiments, the axis of rotation is parallel to the centrallongitudinal axis of the access member.

In certain embodiments, the valve channel of the control valve is linearand is arranged about a valve channel axis. In embodiments, the valveintake port is configured to intersect the valve channel and is arrangedabout a valve intake port axis. In some embodiments, the valve stemincludes a closed side opposing the valve intake port along the valveintake port axis. In embodiments, the closed side of the valve stem ispositioned radial outward of the chamber exit port of the fluidconnector when in the first position of the control valve and intersectsthe flow passage of the fluid connector. In embodiments, the closed sideof the valve stem is configured to close the chamber exit port of thevalve chamber segment of the fluid connector when in the second positionof the control valve. In some embodiments, the closed side of the valvestem is positioned radial inward of the chamber exit port when in thethird position of the control valve and intersects the flow passage ofthe fluid connector.

In embodiments, the control valve includes a valve lever connected tothe valve stem, and configured for manual manipulation and beingselectively movable to move the control valve between the first, secondand third positions.

In some embodiments, the fluid connector and the access housing aremonolithically formed.

In certain embodiments, a closure element is mounted relative to theaccess housing. The closure element is configured to open uponintroduction of the surgical object therethrough and close in theabsence of the surgical object. In embodiments, the fluid passage of thefluid connector is in fluid communication with the longitudinal openingof the access housing and the access member distal of the closureelement.

In one embodiment, an access apparatus includes an access housing, anaccess member extending from the access housing, a fluid connectormounted to the access housing and being configured for coupling to aninsufflation fluid source, and a control valve at least partiallypositioned within the fluid connector. The access housing and the accessmember define a central longitudinal axis and have a longitudinalopening for passage of a surgical object. The fluid connector defines afluid passage extending therethrough, and has an exit port in a sidewall portion thereof in fluid communication with the fluid passage. Thecontrol valve defines a valve channel therethrough and a valve intakeport in fluid communication with the valve channel. The control valve isselectively positionable between a first position corresponding to adesufflation operative state where the valve intake port is aligned withthe fluid passage of the fluid connector and the flow channel is alignedwith the exit port of the fluid connector to permit insufflation fluidsto flow from the access member through the valve intake port fordischarge through the valve channel and the exit port, a second positioncorresponding to an insufflation operative state where the valve channelis aligned with the fluid passage of the fluid connector to permitpassage of insufflation fluids from the insufflation fluid sourcethrough the fluid passage to the access member, and a third positioncorresponding to a closed operative state where the control valveintersects the flow passage of the fluid connector to prevent egress ofinsufflation fluids from the access member.

In embodiments, the fluid connector and the access housing aremonolithically formed. In some embodiments, the control valve isconfigured to rotate about an axis of rotation between the first, secondand third positions whereby the axis of rotation is parallel to thecentral longitudinal axis of the access member.

The integrated fluid connector and control valve permits functioning ofthe apparatus between three operative states, namely, a desufflation, aninsufflation and a closed operative state of operation. The fluidconnector is integrally formed with the access housing and requires onlyone opening in its sidewall. The control valve in combination with thefluid connector permits rapid desufflation even in the absence of aremovable seal system.

Other advantages of the present disclosure will be appreciated from thefollowing description.

BRIEF DESCRIPTION OF THE DRAWING(S)

Embodiments of the present disclosure will be appreciated by referenceto the accompanying drawings wherein:

FIG. 1 is a perspective view of the surgical access apparatus inaccordance with the present disclosure illustrating the access housing,the integrated fluid connector with the control valve mounted to theaccess housing, and the access member extending from the access housing;

FIG. 2 is an exploded perspective view of the access apparatus;

FIG. 3 is a first perspective view of the control valve of the accessapparatus;

FIG. 4 is a second perspective view in partial cross-section of thecontrol valve of the access apparatus;

FIG. 5 is a cross-sectional view taken along the lines 5-5 of FIG. 1illustrating a first position of the control valve corresponding to adesufflation operative state of the access apparatus;

FIG. 6 is a cross-sectional view similar to the view of FIG. 5illustrating a second position of the control valve corresponding to aninsufflation operative state of the access apparatus; and

FIG. 7 is a cross-sectional view similar to the view of FIG. 5illustrating a third position of the control valve corresponding to aclosed operative state of the access apparatus.

DETAILED DESCRIPTION

Particular embodiments of the present disclosure are describedhereinbelow with reference to the accompanying drawings; however, it isto be understood that the disclosed embodiments are merely examples ofthe disclosure and may be embodied in various forms. Well-knownfunctions or constructions are not described in detail to avoidobscuring the present disclosure in unnecessary detail. Therefore,specific structural and functional details disclosed herein are not tobe interpreted as limiting, but merely as a basis for the claims and asa representative basis for teaching one skilled in the art to employ thepresent disclosure in virtually any appropriately detailed structure.

The present disclosure has application in a variety of surgical accessdevices adapted for permitting percutaneous access to a target site.These access devices include, but are not limited to, trocars and/orcannulas, catheters, hand access devices, etc. The present disclosure iscontemplated for use in various surgical procedures including, e.g.,endoscopic, arthroscopic, thoracic, etc., but has particular applicationin a laparoscopic procedure performed in the abdominal cavity.

In the following description, as is traditional, the term “proximal”will refer to the portion of the instrument closest to the clinicianwhile the term “distal” refers to the portion of the instrument mostremote from the clinician.

Referring now to FIGS. 1-2, the access apparatus of the presentdisclosure is illustrated. The access apparatus 10 may be any membersuitable for the intended purpose of accessing a body cavity andtypically defines a passageway permitting introduction of instruments orthe clinician's hand. The access apparatus 10 is particularly adaptedfor use in laparoscopic surgery where the abdominal or peritoneal cavityis insufflated with a suitable fluid or gas, e.g., CO₂, to raise thecavity wall from the internal organs therein. The access apparatus 10 istypically used with an obturator assembly (not shown) which may beblunt, a non-bladed, or a sharp pointed instrument positionable withinthe passageway of the access apparatus 10. The obturator assembly isutilized to penetrate the abdominal wall to introduce the accessapparatus 10 through the abdominal wall, and then subsequently isremoved from the access apparatus 10 to permit introduction of thesurgical instrumentation utilized to perform the procedure through thepassageway.

The access apparatus 10 includes an access housing 12 and an accessmember 14 coupled to the access housing 12. The access housing 12 andthe access member 14 collectively define a longitudinal axis “k”, andhave a longitudinal opening 16 therethrough (cut-away portions of FIGS.1-2). The access member 14 may be cylindrical along at least a portionof its length and defines proximal end segment 18 and distal end segment20. The access number 14 may be a cannula dimensioned for introductionwithin the abdominal cavity “c”, and may include a port opening 22 inits outer wall 14 a in communication with the longitudinal opening 16and adjacent the distal end segment 20 for passage or release ofinsufflation fluids. In the alternative, the access member 14 mayinclude a separate tube or channel for passage of the insufflationfluids. The access member 14, in the form of a cannula, may range from 3mm to 15 mm. In embodiments, the access member 14 has a diameter of 5 mmor less.

The access housing 12 includes a housing segment 24, a closure element26 disposed within the housing segment 24 and a cover 28. The housingsegment 24 and the access member 14 may be monolithically formed as asingle unit, or may be separate components secured to each other throughconventional means. The housing segment 24 defines a semi-hemisphericalor elliptical shape which tapers radially inwardly in the distaldirection relative to the longitudinal axis “k”. The closure element 26is a zero closure valve configured to open upon passage of the surgicalobject therethrough, and close in the absence of the surgical objectand/or in response to pressure provided by the underlying insufflationfluids. The closure element 26 may be a duckbill valve defining a slit26 a which provides a passageway through the closure element 26. Otherzero closure valves are also contemplated. The access housing 12 alsomay include an object seal (not shown) configured to establish a sealingrelation about a surgical object or instrument introduced therethrough.Suitable object seals include septum seals, single slit seals, doubleslit seals or the like.

The cover 28 is secured to the housing segment 24 through conventionalmeans to enclose the closure element 26 and the interior of the accessapparatus 10. The cover 28 includes a central opening 30 which leads tothe longitudinal opening 16. The cover 28 may include diametricallyopposed openings 32 for receiving sutures (not shown) for securing theaccess apparatus 10 relative to the surgical site.

With continued reference to FIGS. 1-2, the access housing 12 furtherincludes a fluid connector 34 depending radially outwardly from theouter surface of the housing segment 24. The fluid connector 34 isintegral with the housing segment 24, and, in one embodiment, ismonolithically formed with the housing segment 24. In the alternative,the fluid connector 34 may be a separate component secured to thehousing segment 24 through a mechanical coupling, adhesive, etc. Thefluid connector 34 includes a valve chamber segment 36 and a couplersegment 38 depending radially outwardly relative to the valve chambersegment 36. The valve chamber segment 36 is arranged around a chamberaxis “m” (FIG. 2) which, in one embodiment, is in general parallelrelation with the central longitudinal axis “k”. The valve chambersegment 36 defines an internal chamber 40 having a generally cylindricalconfiguration, and a single chamber exit port 42 extending through aside wall portion 36 a thereof and in fluid communication with theinternal chamber 40. The coupler segment 38 defines a central flow bore44 therethrough and has an external male thread 46 (e.g., a luercoupling) for coupling to tubing of an insufflation system or source ofpressurized fluids.

Referring now to FIGS. 3-4, in conjunction with FIG. 2, the accessapparatus 10 includes a flow control valve 48 positionable relative tothe valve chamber segment 36 of the fluid connector 34. The controlvalve 48 includes a valve stem 50 and a valve lever 52 coupled to thevalve stem 50. The valve lever 52 is configured for engagement by theclinician to move, e.g., rotate, the control valve 48 relative to thevalve chamber segment 36. The valve stem 50 is generally cylindrical incross-section and is received within the correspondingly dimensionedinternal chamber 40 of the valve chamber segment 36. The valve stem 50includes a linear valve channel 54 arranged about a valve channel axis“b” and extending completely through opposed sides of the valve stem 50and a valve intake port 56 on one side of the valve stem 50 and incommunication with the valve channel 54. (FIG. 4) The valve intake port56 is arranged about a valve intake port axis “e”. The valve stem 50 isclosed on the side opposing the valve intake port 56 (e.g., along thevalve intake port axis “e”) thereby defining a closed side 58 of thevalve stem 50 diametrically opposing the valve intake port 56. In oneembodiment, the valve intake port 56 is oriented at a 90° intervalrelative to the valve channel 54 such that the valve intake port axis“e” of the valve intake port 56 is orthogonal to the valve channel axis“b” of the valve channel 54. Other orientations are also envisioned. Thevalve intake port 56 defines a smaller diameter than the diameter of thevalve channel 54. The valve stem 50 further includes a mounting rib 60adjacent its distal end which defines a mounting recess 62. The mountingrib 60 and/or the mounting recess 62 interact with correspondingstructure (not shown) within the valve chamber segment 36 of the fluidconnector 34 to secure the control valve 48 within the valve chambersegment 36.

The valve stem 50 can be cylindrical in shape with a valve channel thatis linear and passes through the valve stem from a first side to asecond side, opposite the first side. The intake port 56 is orthogonalto the valve channel and opposite the closed side 58, which is formed bya wall of the valve stem.

FIG. 5 illustrates, in cross-section, the assembled access apparatus 10.In FIG. 5, the flow passage “p” extending through the fluid connector 34is also depicted, and is inclusive of the flow bore 44 of the couplersegment 38, the internal chamber 40 of the valve chamber segment 36 andthe intermediate flow bore 64 extending between the valve chambersegment 36 and the housing segment 24 of the access housing 12. The flowpassage “p” permits fluid communication between the insufflation fluidsource, schematically identified as reference numeral 100, and theinterior of the housing segment 24 distal of the closure element 26. Theflow passage “p” is generally arranged around flow axis “s” which, inone embodiment, is orthogonal to the central longitudinal axis “k”.Other arrangements are also envisioned.

FIG. 5 also illustrates a first position of the control valve 48corresponding to the desufflation operative state of the accessapparatus 10. In the first position, the valve intake port 56 of thevalve stem 50 is in alignment with the intermediate flow bore 64 of thefluid connector 34 thereby establishing fluid communication with theaccess member 14, and the valve channel 54 is in alignment with thechamber exit port 42 of the valve chamber segment 36. The closed side 58of the valve stem 50 is in alignment with, and intersects, the flow bore44 of the coupler segment 38 thereby closing the fluid passage “p” tothe insufflation fluid source 100. The closed side 58 of the valve stem50 is disposed radial outward of the chamber exit port 42. Thus, in thefirst position, the insufflation fluids “f” may be conveyed from theaccess member 14 and the housing segment 24 into the fluid connector 34and passed through the valve intake port 56 and the valve channel 54 ofthe valve stem 50, to rapidly exit the chamber exit port 42 of the valvechamber segment 36.

FIG. 6 illustrates a second position of the control valve 48corresponding to the insufflation operative state of the accessapparatus 10. In the second position, the closed side 58 of the valvestem 50 intersects, blocks or covers the chamber exit port 42 of thevalve chamber segment 36 while the valve channel 54 of the valve stem 50is in alignment with the flow bore 44 of the coupler segment 38 therebycompletely opening the flow passage “p” through the fluid connector 34.Thus, in the second position, the insufflation fluids “f” will pass fromthe insufflation fluid source 100 through the fluid connector 34 andinto the housing segment 24 and/or access member 14 distal of theclosure element 26 within the access housing 12.

FIG. 7 illustrates a third position of the control valve 48corresponding to the closed operative state of the access apparatus 10.In the third position, the closed side 58 of the valve stem 50 isdisposed radial inward of the chamber exit port 42, and is arranged tointersect or block the intermediate flow bore 64 of the fluid connector34 thereby closing the fluid passage “p” of the fluid connector 34relative to the access member 14, e.g. preventing egress of insufflationfluids “f” from the access member 14. In the third state, thepneumoperitoneum is maintained without passage of insufflation fluidsbetween the insufflation fluid source 100 and the access member 14. Theinsufflation fluid source 100 also may be deactivated through, e.g.,closing a valve associated with the insufflation fluid source 100 orturning the source to an off-mode of operation.

The use of the access apparatus 10 will now be discussed. The accessapparatus 10 is introduced through the abdominal wall to access theunderlying abdominal cavity. In accordance with one methodology, anobturator (not shown) is positioned within the access apparatus 10 andadvanced through the abdominal wall, e.g., through a previously createdincision in the abdominal wall or through an opening created by theobturator, to position at least the distal end segment 20 of the accessmember 14 within the abdominal cavity “c” as depicted in FIG. 1. Priorto accessing the abdominal cavity “c”, the abdominal cavity “c” may beat least partially or fully expanded with insufflation fluids, CO₂,introduced via an insufflation needle to establish a pneumoperitoneum. Asurgical object, e.g., a laparoscopic surgical instrument such as agrasper, scissor, electrosurgical device, stapler, etc. may be advancedthrough the access apparatus 10 and into the underlying surgical site toperform a surgical task. If, during the procedure, insufflation fluidsare required to establish or maintain the pneumoperitoneum, the controlvalve 48 may be oriented to the position of FIG. 6 corresponding to theinsufflation operative state thereby permitting passage of insufflationfluids from the insufflation fluid source 100 through the fluidconnector 34 and into the access member 14 for delivery within theabdominal cavity “c”. When the desired state of pneumoperitoneum isachieved, the control valve 48 may be manipulated to the position ofFIG. 7 corresponding to the closed operative state which blocks egressof the insufflation fluids through the flow passage “p” of the fluidconnector 34 and through the control valve 48. Upon completion of thesurgery or when it is determined that rapid desufflation of theabdominal cavity is required, the control valve 48 is maneuvered to thefirst position depicted in FIG. 5 corresponding to the desufflationoperative state, which aligns the valve intake port 56 of the valve stem50 with the intermediate flow bore 64 of the fluid connector and alignsthe valve channel 54 with the chamber exit port 42 of the valve chambersegment 36. Thus, in the first position, the insufflation fluids “f” maypass through the access member 14 and the access housing 12 into thefluid connector 34 through the valve intake port 56 and the valvechannel 54 and rapidly exit the chamber exit port 42 of the valvechamber segment 36.

Thus, the integrated fluid connector 34 and control valve 48 of thepresent disclosure provides the ability of quick desufflation withoutrequiring removal of a detachable seal system. Only one exit hole,chamber exit port 42, is required in the side wall of the fluidconnector 34 and, in combination with the respective configurations ofthe valve channel 54 and the valve intake port 56 of the valve stem 50,permits ready transition between the three operative states of theaccess apparatus 10.

The above description and the drawings are provided for the purpose ofdescribing embodiments of the present disclosure and are not intended tolimit the scope of the disclosure in any way. It will be apparent tothose skilled in the art that various modifications and variations canbe made without departing from the spirit or scope of the disclosure.Thus, it is intended that the present disclosure cover the modificationsand variations of this disclosure provided they come within the scope ofthe appended claims and their equivalents.

What is claimed is:
 1. An access apparatus, comprising: an accesshousing; an access member extending from the access housing, the accesshousing and the access member defining a central longitudinal axis andhaving a longitudinal opening for passage of a surgical object; a fluidconnector mounted to the access housing, the fluid connector including avalve chamber segment and a coupler segment depending radially outwardlyrelative to the valve chamber segment and the longitudinal axis, thefluid connector defining a fluid passage extending at least through thevalve chamber segment and the coupler segment, the valve chamber segmentdefining a chamber exit port in fluid communication with the fluidpassage, the coupler segment configured for coupling to an insufflationfluid source; and a control valve including a valve stem at leastpartially positioned within the valve chamber segment, the valve stemincluding a valve channel extending through the valve stem and a valveintake port in fluid communication with the valve channel, the controlvalve selectively positionable between a first position corresponding toa desufflation operative state where the valve intake port is in fluidcommunication with the access member and the valve channel is in fluidcommunication with the chamber exit port of the fluid connector tothereby permit exit of the insufflation fluids relative to the accessmember, a second position corresponding to an insufflation operativestate where the valve channel is in fluid communication with the fluidpassage of the fluid connector and with the insufflation fluid source topermit passage of insufflation fluids from the insufflation fluid sourceto the access member, and a third position corresponding to a closedoperative state where the valve stem intersects the fluid passage toprevent egress of insufflation fluids from the access member, whereinthe control valve is configured to rotate about an axis of rotationbetween the first, second, and third positions, the axis of rotationbeing parallel to the central longitudinal axis of the access member. 2.The access apparatus of claim 1 wherein the valve channel of the controlvalve is linear and is arranged about a valve channel axis.
 3. Theaccess apparatus of claim 2 wherein the valve intake port is configuredto intersect the valve channel and is arranged about a valve intake portaxis.
 4. The access apparatus of claim 3 wherein the valve stem includesa closed side opposing the valve intake port along the valve intake portaxis.
 5. The access apparatus of claim 4 wherein the closed side of thevalve stem is positioned radial outward of the chamber exit port of thefluid connector when in the first position of the control valve andintersects the flow passage of the fluid connector.
 6. The accessapparatus of claim 5 wherein the closed side of the valve stem isconfigured to close the chamber exit port of the valve chamber segmentof the fluid connector when in the second position of the control valve.7. The access apparatus of claim 6 wherein the closed side of the valvestem is positioned radial inward of the chamber exit port when in thethird position of the control valve and intersects the flow passage ofthe fluid connector.
 8. The access apparatus of claim 1 wherein thecontrol valve includes a valve lever connected to the valve stem, thevalve lever configured for manual manipulation and selectively movableto move the control valve between the first, second and third positions.9. The access apparatus of claim 1 wherein the fluid connector and theaccess housing are monolithically formed.
 10. The access apparatus ofclaim 1 including a closure element mounted relative to the accesshousing, the closure element configured to open upon introduction of thesurgical object therethrough and close in the absence of the surgicalobject.
 11. The access apparatus according to claim 10 wherein the fluidpassage of the fluid connector is in fluid communication with thelongitudinal opening of the access housing and the access member distalof the closure element.
 12. An access apparatus, comprising: an accesshousing; an access member extending from the access housing, the accesshousing and the access member defining a central longitudinal axis andhaving a longitudinal opening for passage of a surgical object; a fluidconnector mounted to the access housing and being configured forcoupling to an insufflation fluid source, the fluid connector defining afluid passage extending therethrough, the fluid connector defining asingle exit port in a side wall portion thereof in fluid communicationwith the fluid passage; and a control valve at least partiallypositioned within the fluid connector, the control valve defining avalve channel therethrough and a valve intake port in fluidcommunication with the valve channel, the control valve selectivelypositionable between: a first position corresponding to a desufflationoperative state where the valve intake port is aligned with the fluidpassage of the fluid connector and the flow channel is aligned with theexit port of the fluid connector to permit insufflation fluids to flowfrom the access member through the valve intake port for dischargethrough the valve channel and the exit port; a second positioncorresponding to an insufflation operative state where the valve channelis aligned with the fluid passage of the fluid connector to permitpassage of insufflation fluids from the insufflation fluid sourcethrough the fluid passage to the access member; and a third positioncorresponding to a closed operative state where the control valveintersects the flow passage of the fluid connector to prevent egress ofinsufflation fluids from the access member, wherein the control valve isconfigured to rotate about an axis of rotation between the first,second, and third positions, the axis of rotation being parallel to thecentral longitudinal axis of the access member.
 13. The access apparatusof claim 12 wherein the fluid connector and the access housing aremonolithically formed.